Improving Neuropsychological Rehabilitation for COVID-19 Patients

Abstract

Cognitive sequelae after recovery from an initial COVID-19 disease are present in a subset of affected individuals, coalescing around several important issues such as effects of age, COVID-19 disease severity, comorbidities, and other factors. Some neuropsychological symptoms appear more common among certain patient populations. Comorbidities may complicate neuropsychological assessment as well. Hence, we need a guideline-based evaluation to guide neuropsychological rehabilitation. Drawing from the recent revision of the German National Guideline for the Long- and Post-COVID Syndrome and current advances in international guidance on neuropsychological assessment, this article provides practical and scientifically informed recommendations for the neuropsychological assessment of individuals recovering from coronavirus-related diseases.

Long COVID: neurological manifestations - an updated narrative review

“…It is evident that not only individuals infected with SARS-COV-2 but also family members and the healthy population, since the beginning of the pandemic in Wuhan in 2020, have had psychiatric impairments due to the situation prevailing in the period, mainly related to behavioral changes of social and sanitary restriction 45 , 47 . In the same manner, long COVID can also promote feelings of isolation and trauma in an individual and other nonpsychiatric symptoms can trigger psychological burdens, such as fatigue leading to reduced motivation 48 . The aetiology of the neuropsychiatric causes of COVID-19 in regard to the interaction of the virus with the central nervous system is diverse and includes imbalanced neurotransmitters, disruption of the blood-brain barrier, promotion of hypoxia and unbalanced immune response.…”

“…Furthermore, it represents a new context of a virus of global impact on society 45 , 46 . It’s important to highlight that although the biological mechanisms that alter brain structure and function are important in augmenting neuropsychological changes, minor changes in non-eloquent regions of the brain can also promote subtle yet complex effects 48 . Depressive symptoms, in varying degrees, and clinically relevant post-traumatic stress disorder (PTSD) have been documented in patients who had COVID-19 even 22 months after infection, and a correlational analysis showed that stronger PTSD symptoms were correlated with poor performance in Weigl’s test and attentional matrices 49 .…”